Special Theme: Advising and Supporting Underrepresented Minority Students

Dramatic racial and ethnic changes in the demographics of the United States make increasing the diversity of the health professions workforce a pragmatic as well as a moral imperative. Yet, despite years of concerted effort, African Americans, Hispanics, and Native Americans continue to be underrepresented in the health professions (COME, 1998; AADS, 2000; AAMC, 2000a,b). Addressing this persistent problem requires proactive, systemic approaches at all levels of the educational process. Whether the metaphor used is the “pipeline” or Bowen and Bok’s Shape of the River (13 Owen & Bok, 1998), the educational system loses many minority students during the undergraduate years.

This is especially the case for minority students who enter colleges and universities expressing an interest in the health professions, regardless of their intellectual abilities (Bowen & Bok, 1998; CB, 1999; Gandara, 1999). Attention to the undergraduate years of academic preparation and personal growth is, therefore, essential to achieving the goal of a health professions workforce that reflects the racial and ethnic diversity of this country. The pervasive inequities in education that leave many underrepresented minority students ill prepared for the rigors of advanced education have been well documented. These inequities severely limit the pool of students entering colleges and universities (NCES, 1998; NSF, 2000). Therefore, it is imperative that under-graduate institutions provide the programmatic and personal support necessary to ensure the persistence of minority students to the baccalaureate. With respect to the health professions, effective undergraduate prehealth advising programs play a unique and important role in the successful advancement of under-represented minorities to careers in the health professions.

Understanding the root causes of the under-representation of minorities in the health professions will facilitate the development of effective strategies for remedying the problem. For example, poor academic performance in science and math courses often impedes the advancement of minority students to health professions schools. Because the factors influencing their performance in rigorous science and mathematics courses are complex, the solutions must be equally creative and multifaceted to have an impact. Several studies on the persistence of minority students to the baccalaureate in all majors, particularly in science and math, illuminate the complexity.

The current academic year has proven to be active and productive for NAAHP’s Committee on Minority Affairs. We have formed an active and invested Committee of advisors and liaison members, have secured grant funding for the upcoming national conference, and are in the process of building some very important liaison relationships with relevant professional associations. Let us give you a little background before we share more about what is planned.

What is the Problem?
The problem of decreasing numbers of underrepresented minority students (URMs) — African-Americans, Hispanics and Native Americans — who are recruited and retained in the pursuit of careers in the health professions continues to be an issue in medical education in the United States (see AAMC report “Minority Graduates of U.S. Medical Schools: Trends, 1950-1998”). Medical Schools and the AAMC have worked toward increasing the size of the URM applicant population and improving the credentials and retention of these students in the applicant pool. Project 3000 by 2000, while increasing somewhat the numbers of URM students, did not achieve the goal of 3000 accepted students in the medical school class matriculating in 2000. Most educators are aware of the inequality in teaching and schooling for URMs in this country and how opportunity is often rationed to minority students. This is a pipeline problem that often begins in preschool and extends into the college experience.

Related to this, there is a compelling need for cultural competence among health professions advisors. Cultural competency permits individuals to respond with respect and empathy to people of all cultures, classes, races, religions and ethnic backgrounds in a manner that recognizes, affirms and values the worth of individuals, families, and communities. It is generally assumed that health professions advisors can more sensitively and optimally advise underrepresented students across cultural lines by examining their knowledge, attitudes, skills, and protocols in advising.

The Role of Health Professions Advisors
Health professions advisors in colleges and universities can play an integral role in the recruitment and retention of URMs into health careers. Ideally, advisors can provide access to resources and opportunities for URMs as well as provide encouragement and support throughout the educational process. They often serve as gatekeepers, facilitating the candidacy of minority applicants to health professions schools. It is recognized, however, that health professions advisors can either positively or negatively impact access, opportunities, persistence, and the ultimate success of URMs. Advisors, like all people, are susceptible to attitudes and practices of racial and ethnic stereotyping, specifically those that unintentionally have a negative impact on the confidence and persistence of URMs.

Excerpts from the Report of the American Association of Colleges of Pharmacy ad hoc Committee on Affirmative Action and Diversity

The AACP Ad Hoc Committee on Affirmative Action and Diversity felt the need to establish why it is so important to pharmacy education that students from all racial and ethnic groups be well represented in the nation’s colleges and schools of pharmacy. Committee members determined that there is a unique element to the practice of pharmacy that requires diversity to achieve the goals of professional pharmacy practice. First and foremost, pharmacists are health care providers responsible for achieving positive health outcomes for all patients, regardless of background. Pharmacists are placed in a more diverse environment today than in the past. Pharmacists, in contemporary practice, need to possess communication skills unprecedented in the history of pharmaceutical care. Additionally, pharmacists are required to work in a closer relationship with patients and other health professionals than ever in order to achieve the goals of pharmaceutical care. This is primarily a result of the rapidly changing demographic composition of the United States. As the new millennium begins, ethnic minorities comprise an estimated 27% of the U.S. population. Reliable estimates indicate that their numbers will increase to 37% in the year 2025 (U.S. Census Bureau, 1999). The increasing numbers of minority persons will continue to create social and political changes throughout society. This will occur particularly in health care, where pressure on financing and delivery systems to close the gap in health status between minorities and the majority population can only increase. Moreover, because minorities are underrepresented in all health professions, including pharmacy, pressures should intensify to achieve greater representation of minorities in the health care workforce.

Purpose
To gain a greater understanding of the perceptions of underrepresented minority premedical students regarding premedical preparation and the medical school admissions process.

Method
A 36-item questionnaire was administered to 116 undergraduate premedical students attending a summer enrichment program. Responses for most questions were scored on a Likert-type scale.

Results
Respondents reported high utilization of premedical advising services and rated these services as helpful. However, the majority of respondents overestimated both the competition for medical school admissions and the representation of minority students in the medical school population. Respondents had a realistic perception of the importance of quantitative factors (grades, MCAT scores) and more qualitative/humanitarian factors (communication skills, community service) in medical school admissions and tended to rate themselves as above average as medical school candidates based on these factors. Areas in which respondents reported lower levels of preparation include research experience and medically-related reading.

Conclusion
The findings suggest several avenues in which premedical advisors and/or enrichment program could assist minority premedical students in preparing for medical school admissions. These include providing a list of information resources, recommended reading lists, and up-to-date data on admissions trends, especially for minority applicants.

Why Xavier University Remains Number 1Pearl Stewart

Promoting MulticulturalismConnie O'Hara

How do we promote and develop a diverse, culturally competent workforce of physicians to meet the needs of our changing society? This issue was explored by 37 health professions advisors and numerous administrators from eight different medical schools at the sixth annual joint meeting of the Philadelphia LAN on January 4, 2002. The event, hosted by Drs. Carol Terregino and David Seiden at Robert Wood Johnson Medical School’s Camden campus, featured a keynote presentation, a panel of medical school administrators, and small group discussions on the issue of diversity.